Stage of Healing

On rural prac doing musculoskeletal outpatients I was referred a patient for management of his broken ribs. As a result of the patient having a fracture it was important as I know now what the contraindications/precautions would be for someone following fracture.

The standard assessment form was used for all new patients. In the OE for spinal assessment the headings were - AROM, PAIVMS, PPIVMS etc etc. Without taking the underlying pahology into consideration I started doing AROM of the Thx spine. Following end range pain I decided I would do PAIVMS. Luckly I stopped and thought, if i PAIVM his thoracic spine will that to produce motion at his rib fracture.

I thought to myself, if the patient had a broke ankle would i mobilise it a week after fracture? Similarly I tailored my management of this patient taking a more prophylatic approach to his fracture, performing a cardio assessment and giving him DB exercises.

Through encoutering this patient it highlight to me how important was to keep clinically reasoning while your performing assessment and treatments. If I had mobilised his thoracic spine maybe it might have caused a puncture lung or something more serious. In future treatments it is important for me to take things slower, stop and think what is going here? what is the stage of healing? Is my treatment indicated for this patient?